Swedish suicide survivors help fight stigma

'Attitude ambassadors' are touring communities in a bid to reduce Sweden's suicide rate - and it appears to be working.

Stockholm, Sweden - Hakan Wingren remembers vividly the clear, sunny day in August 2006 when he came close to killing himself.

The Swedish businessman was in the vortex of a deep depression; he was alone by the sea at his summer house, painted red.

"I wrote my farewell letter and I went out to the garden to find a rope. I found a rope and I was standing holding the rope, a warm, fantastic rope," Wingren said, his large hands curling to the feel of what would have been the means to his death.

I wrote my farewell letter and I went out to the garden to find a rope.

Hakan Wingren, Attitude Ambassador

But something stopped him, a brief thought of his wife, two sons and daughter and he stepped back from his plan. Wingren spent a month in a secure unit at a mental hospital and had five electric shock treatments. He now takes anti-depressants, sees a psychiatrist regularly and declares himself as "repaired".

Wingren is one of Sweden's 350 Attitude Ambassadors, people who've tried to kill themselves or have come close to trying. They go out into the community: schools, hospitals and libraries to tell their stories and give hope to others who are suffering from mental illness.

For Wingren, a 70-year-old retired energy executive, speaking to businesses is a priority.

"When I was depressed, I was walking around the office like a zombie. I couldn't go into the coffee room and joke with my colleagues. No-one asked me any direct questions," he said. "But if my boss had been less sympathetic, if he'd said, 'Hakan, you're useless at your work', that could have been a trigger for suicide."

Attitude ambassadors are just one of the strategies Sweden is using to reduce its suicide rate. And there's no doubt the country has a problem.

"One in four Swedes has a mental illness. Three out of four people have someone close to them who has experience of mental illness," explained Lena Eidevall, head of research and development at Lund's psychiatric hospital.

Suicide among men aged 15 to 44 is the most common cause of death in Sweden, according to the country's National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP).

But suicide reduction is a priority for officials here, and it appears to be successful.

"Scientific evidence proving it works is impossible, as there is no control group of the same country without a suicide prevention plan - but we believe the Swedish model is working," said Vladimir Carli, a NASP researcher.

The country's multi-faceted strategy includes reducing the stigma attached to mental illness by talking about it and breaking the taboos that surround psychiatric problems.

"If you have a skin cancer on your face your friends or family will say: 'Hey, what's that? You'd better get it checked.' But with mental illness no-one wants to talk about it, and by the time the problem appears it could be too late," said Gergo Hadlaczki, deputy director of NASP.

...With mental illness no-one wants to talk about it, and by the time the problem appears it could be too late.

Gergo Hadlaczki, NASP,

Parliament ratified a suicide prevention programme in 2008; the government funds research into suicide and myriad programmes designed to prevent deaths.

Carl Essen runs an internet hotline in central Stockholm; the clients are primarily young people.

Pots of coffee and Swedish rye bread with butter and jam are on hand for the four volunteers at their screens giving advice, answering questions and just being a human presence responding to an online conversation.

"We are busy continuously. Every night there are 15 to 20 chats," Essen explained. The charity also has a telephone hotline, but Essen said most young people prefer the anonymity of a computer.

"You can use your voice for power. Many of these young people may feel inferior having a conversation about their mental health," Essen said.

Hjarnkoll, an NGO trying to reduce the stigma of mental illness, has produced a New First Aid kit for the workplace. It's only a prototype for now, but the kit is designed to replace the old wall-mounted boxes containing bandages and plasters.

The New First Aid kit still includes the traditional treatments - but on the front, there's a questionnaire asking people about their mental health. Are they stressed, sleeping poorly, unable to cope? Below the questionnaire is a number to call for help.

Hjanrkoll's director, Rickard Bracken, said the most powerful tool in the community for fighting mental illness is the ambassador programme - people such as Hakan Wingren whose mental illness brought him to the brink of suicide.

"When I held that rope, suddenly I thought: 'Can I do this?" Wingren said. "Now, when I talk to people, I can see that I give them some hope - to talk openly about mental illness gives you strength."

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